Scientists finally discover how stress can cause heart problems

Stress is something we're all familiar with. And, although scientists believe a moderate amount of stress to be a good thing, increased and prolonged stress is thought to lead to a number of health problems - including an increased risk of heart disease.

Experts have puzzled for years over the relationship between chronic anxiety and cardiovascular issues, but now it seems they may have an answer. A study undertaken by US researchers has directly linked high stress levels with an increased risk of heart attacks and strokes for the first time by identifying a region of the brain that is responsible.

Stress and amygdala

The research, published in The Lancet and led by a team from Harvard medical school, scanned the brain, bone marrow, spleen and arteries of 293 patients. These participants were then tracked for around four years to see if they developed cardiovascular disease. In this time 22 patients had cardiovascular events including heart attack, angina, heart failure, stroke and peripheral arterial disease.

A second, smaller study of just 13 patients looked at the relationship between stress levels and inflammation in the body. Overall, it was found that those who reported the highest levels of stress had the highest levels of amygdala (the centre for emotions, like fear and anger, emotional behavior and motivation) activity.

The researchers also found that the heightened activity in the amygdala was linked to increased bone marrow activity and inflammation in the arteries. The scientists suggest amygdala may signal to the bone marrow to produce extra white blood cells, possibly causing heart attack and stroke.

Although animal studies have previously identified a link between stress and higher activity in the bone marrow and arteries, until now it has remained unclear whether this also applies to humans.

What does this mean?

While more research and larger studies are needed to confirm the mechanism, the researchers suggest that these findings could eventually lead to new ways to target and treat stress-related cardiovascular risk. Dr Ahmed Tawakol, the study's lead author, said:

"Our results provide a unique insight into how stress may lead to cardiovascular disease. This raises the possibility that reducing stress could produce benefits that extend beyond an improved sense of psychological wellbeing. Eventually, chronic stress could be treated as an important risk factor for cardiovascular disease, which is routinely screened for and effectively managed like other major cardiovascular disease risk factors."

As a result, researchers have recommended that chronic and social stress be considered a major danger when it comes to cardiovascular health, taking a place alongside smoking, high blood pressure and diabetes as a known cause.

What else are the experts saying?

A 2013 survey by Bupa found that almost half of UK adults considered themselves to be stressed, the most affected of whom fell into the 45-54 age group – the age at which cardiovascular risk begins to increase.

It may allow us to develop new ways of managing chronic psychological stress

Emily Reeve, Senior Cardiac Nurse at the British Heart Foundation, voiced hopes that new research could pave the way for stress management:

"The link between stress and increased risk of developing heart disease has previously focused on the lifestyle habits people take up when they feel stressed such as smoking, drinking too much alcohol and overeating. Exploring the brain's management of stress and discovering why it increases the risk of heart disease, will allow us to develop new ways of managing chronic psychological stress. This could lead to ensuring that patients who are at risk are routinely screened and that their stress is managed effectively."

Try to make positive lifestyle changes to reduce stress

Mr Neil Roberts, a consultant cardiac surgeon specialising in adult cardiac surgery at Spire St Anthony's Hospital and The Heart Hospital, said the research offers an explanation for unlikely cases of cardiac problems.

"From a clinical perspective, this may explain why some people without the typical, and more well-known risk factors for cardiovascular disease (smoking, diabetes, high blood pressure, high cholesterol, etcetera) do develop cardiovascular disease. What is even more important, is that each individual can take this evidence and reflect on their own risk for cardiovascular disease and, in the time of New Year's Resolutions, try to make some positive lifestyle choices and reduce as many risk factors as they can, including stress."

He added:

"I will use this evidence by continuing to reduce stress by taking enough time to exercise regularly, try and eat a healthy mediterranean style diet and keep my weight under control, but I will also continue to enjoy the occasional glass of good quality red wine which has also been shown to reduce cardiovascular disease and also theoretically can reduce stress too."

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